System and Method for Determining Drug Usage by Indication

Abstract

A computer-assisted method that includes: identifying practitioners affiliated with a non-retail facility; gathering longitudinal prescription scripts by the identified prescribing practitioners as well as medical claims submitted by the identified prescribing practitioners to insurance carriers; linking the medical claims submitted by the identified practitioners to the longitudinal prescription scripts; based on each linked medical claim and longitudinal prescription script, generating a record of using the prescription drug for the corresponding one or more indication; generating a distribution factor of using the prescription drug for each of the one or more indications by the identified practitioners outside the non-retail facility; receiving information showing a volume of the prescription drug sold to the non-retail facility; and generating usage data by indications of the prescription drug for the non-retail facility by applying the generated distribution factor to the received information showing the volume of the prescription drug sold to the non-retail facility.

1 . A computer-implemented method for generating usage data of a prescription drug for one or more indications, the method comprising:
 identifying practitioners affiliated with a non-retail facility;   gathering longitudinal prescription scripts by the identified practitioners as well as medical claims submitted by the identified practitioners to insurance carriers,
 wherein each prescription script includes information representing a unique patient identifier that does not reveal a patient's identity, and a prescribed drug; 
 wherein each medical claim includes information representing a unique patient identifier that does not reveal the patient's identity, and at least one indication; 
   linking the medical claims submitted by the identified practitioners to the longitudinal prescription scripts at least in part based on a matching unique patient identifier that does not reveal the patient's identity;   based on each linked medical claim and longitudinal prescription script, generating a record of using the prescription drug for the corresponding one or more indication by the matching practitioner outside the non-retail facility;   generating a distribution factor of using the prescription drug for each of the one or more indications by the identified practitioners outside the non-retail facility;   receiving information showing a volume of the prescription drug sold to the non-retail facility; and   generating usage data for each of the one or more indications of the prescription drug for the non-retail facility by applying the generated distribution factor of using the prescription drug for each of the indications by the identified physicians outside the non-retail facility to the received information showing the volume of the prescription drug sold to the non-retail facility.   
     
     
         2 . The method of  claim 1 , further comprising:
 generating the distribution factor that shows a distribution of usage among the one or more indications of the prescription drug.   
     
     
         3 . The method of  claim 2 , further comprising:
 applying the generated distribution factor by weighing the prescription patterns of the identified physicians outside the non-retail facility.   
     
     
         4 . The method of  claim 3 , wherein the weighing includes consolidating individual distributions of the identified physicians outside the non-retail facility according to respective prescription volumes of the identified physicians outside the non-retail facility. 
     
     
         5 . The method of  claim 4 , wherein consolidating individual distributions of the identified physicians outside the non-retail facility further accounts for a respective ratio of time allocation by each of the identified physicians outside the non-retail facility and inside the non-retail facility. 
     
     
         6 . The method of  claim 1 , further comprising:
 identifying practitioners in a locale;   gathering longitudinal prescription scripts by the identified practitioners filled at retail stores in the locale as well as medical claims submitted by the identified practitioners to insurance carriers;   linking the medical claims to the longitudinal prescription scripts at least in part based on a matching unique patient identifier that does not reveal the patient's identity;   compiling usage data for each of the one or more indications of the prescription drug in the locale.   
     
     
         7 . The method of  claim 6 , wherein the locale is identified by a zip code. 
     
     
         8 . The method of  claim 6 , further comprising:
 combining usage data by indications of the prescription drug for a particular indication from retail stores and usage data by indications of the same prescription drug and the same indication from non-retail facilities.   
     
     
         9 . The method of  claim 8 , further comprising:
 generating the combined usage data over a sliding window of time.   
     
     
         10 . The method of  claim 9 , wherein the sliding window of time spans over a period immediately preceding a particular time point. 
     
     
         11 . The method of  claim 8 , further comprising:
 tracking the combined usage data over time.   
     
     
         12 . The method of  claim 1 , further comprising:
 receiving data showing office visits at the non-retail facility for the particular indication, the office visits data referencing more than one prescription drug for treating the particular indication.   
     
     
         13 . The method of  claim 1 , further comprising:
 calibrating the generated usage data by indications at the non-retail facility by:
 aggregating the generated usage data for the particular indication over the more than one prescription drug; and 
 comparing the aggregated usage data for the particular indication with office visit data at the non-retail facility for the particular indication. 
   
     
     
         14 . The method of  claim 1 , further comprising:
 receiving consumption data by a particular indication from a reporting facility that combines contributions from the more than one prescription drug and from non-retail facilities in one or more locales.   
     
     
         15 . The method of  claim 14 , further comprising receiving consumption data by the particular indication from the reporting facility that combines contributions from the more than one prescription drug and from non-retail facilities at a national level. 
     
     
         16 . The method of  claim 14 , further comprising:
 calibrating the generated usage data by indications by:   aggregating the generated usage data by the particular indication over the more than one prescription drug and from non-retail facilities in the one or more jurisdictions; and   comparing the aggregated usage data to the received consumption data from the one or more jurisdictions.   
     
     
         17 . The method of  claim 1 , wherein linking the medical claims to the longitudinal prescription scripts further comprises: linking the medical claims to the longitudinal prescription scripts with a matching practitioner or a matching office visit. 
     
     
         18 . The method of  claim 1 , wherein the non-retail facility includes a hospital, a clinic, or a long-term care facility. 
     
     
         19 . The method of  claim 18 , wherein the long-term care facility includes a rehabilitation facility, a nursing facility, an in-patient mental health facility, or an in-patient chronic care facility. 
     
     
         20 . The method of  claim 1 , wherein each prescription script further includes information representing a prescribing practitioner, and wherein each medical claim further includes information representing an office visit date, a rendering physician, a drug dispensed by the rendering physician. 
     
     
         21 . A computer comprising one or more processors, configured to perform the operations of:
 identifying practitioners affiliated with a non-retail facility;   gathering longitudinal prescription scripts by the identified practitioners as well as medical claims submitted by the identified practitioners to insurance carriers,
 wherein each prescription script includes information representing a unique patient identifier that does not reveal a patient's identity, and a prescribed drug; 
 wherein each medical claim includes information representing a unique patient identifier that does not reveal the patient's identity, and at least one indication; 
   linking the medical claims submitted by the identified practitioners to the longitudinal prescription scripts at least in part based on a matching unique patient identifier that does not reveal the patient's identity;   based on each linked medical claim and longitudinal prescription script, generating a record of using the prescription drug for the corresponding one or more indication by the matching practitioner outside the non-retail facility;   generating a distribution factor of using the prescription drug for each of the one or more indications by the identified practitioners outside the non-retail facility;   receiving information showing a volume of the prescription drug sold to the non-retail facility; and   generating usage data for each of the one or more indications of the prescription drug for the non-retail facility by applying the generated distribution factor of using the prescription drug for each of the indications by the identified physicians outside the non-retail facility to the received information showing the volume of the prescription drug sold to the non-retail facility.   
     
     
         22 . A computer-readable medium, comprising software instructions, that when executed by a computer, cause the computer to execute the operations of:
 identifying practitioners affiliated with a non-retail facility;   gathering longitudinal prescription scripts by the identified practitioners as well as medical claims submitted by the identified practitioners to insurance carriers,
 wherein each prescription script includes information representing a unique patient identifier that does not reveal a patient's identity, and a prescribed drug; 
 wherein each medical claim includes information representing a unique patient identifier that does not reveal the patient's identity, and at least one indication; 
   linking the medical claims submitted by the identified practitioners to the longitudinal prescription scripts at least in part based on a matching unique patient identifier that does not reveal the patient's identity;   based on each linked medical claim and longitudinal prescription script, generating a record of using the prescription drug for the corresponding one or more indication by the matching practitioner outside the non-retail facility;   generating a distribution factor of using the prescription drug for each of the one or more indications by the identified practitioners outside the non-retail facility;   receiving information showing a volume of the prescription drug sold to the non-retail facility; and   generating usage data for each of the one or more indications of the prescription drug for the non-retail facility by applying the generated distribution factor of using the prescription drug for each of the indications by the identified physicians outside the non-retail facility to the received information showing the volume of the prescription drug sold to the non-retail facility.